In the UK, clinicians may write a DNR order without consent, if they deem that to be in the patient’s best interest. But clinicians must still consult with the patient or family. In other words, they may write a unilateral DNR order. But they may not write a “secret” DNR order.
Yet, as I have recounted on this blog more than a dozen times, this continues to happen. One of the most recent cases occurred in August 2014 at Ayr Hospital.
In an apology letter to the family, the said: “I wish to offer my sincere apologies again on behalf of all the staff concerned for the distressing events you have described, and wish to reassure you that lessons have been learned and that practice around DNACPR decisions are being reviewed and improved as a matter of urgency across the organization. . . . It is evident from the review of Mrs Gibson’s medical records, and discussions with staff involved, there were failures in communicating the medical decisions around resuscitation to Mrs Gibson and yourselves.”